Anaesthesia: how do dental/oral surgeons decide?

[snowmash]

I really want to ask if they can pull my teeth with just a local anaesthetic (care of DC, had several general anaesthetics this year, and had a GA that I did not consent to, so I am not keen on another, wimp that I am ).

I also think the waiting list would be shorter, and they might pull fewer teeth (don't mind losing them, just don't fancy recovering from having all wisdoms and failed root canals pulled at the same time).

I can find lots of people online who have found sedation/GA successful, but cannot really find anyone who has asked for local anaesthetic instead.

So I am wondering if anyone's been told the benefits of local vs. general anaesthesia? I'm not sure if an airway would make extractions harder to do.

IV sedation is the half way point. You get it at the dentists and the recovery is very fast. In theory you would be unable to look after children for the rest of the day. You are awake but cannot remember any of the surgery.
I had one tooth out with just local and it was fine. But I wouldn't like to have loads out without just being knocked out a bit. They will do it though I'm sure unless the wisdom teeth are tricky and require more surgery.

I had a w3isdom tooth out under a local, which was fine just had a root canal done yesterday and that was a worse procedure (took longer/drilling etc)

Thanks nikos - unfortunately the consultant at my dentist has already said no to sedation (she got as far as 'this is x and she has y' before he said no).

That's good to hear that both of you have had one out under local, and that it's easier than a root canal - I've been told that if they go in under GA they will pull the 'potentially suspicious' as well as the 'definitely need removing' because of the risks, whereas if I can persuade them to try local, they will only take the definitely need to come out ones.

I had wisdom teeth out and root canal done under a local- admittedly one at a time.

I didn't feel anything- so I don't see why you couldn't have them done this way.

My dad has various health conditions which mean that he only has GAs as a very last resort. He has has several fairly complex dental implants fitted, all at dental hospital because of his health complications, but none under GA. All under local.

So it is possble.

I don't know what it's like though. I had all 4 wisdom teeth out under general, and have had two RC under local. My dad has incredible mental strength. RCA are about as much as I can cope with awake.

Thanks winnybella and PrettyCandles. That's really good to know that the hospital dental service will do work under local - sounds definitely worth a try!

There is no reason that an extraction cannot be done under LA, as a routine procedure. I have assisted with many exactions under local, some quite involved & some with surgical intervention.

It won't make any difference to the healing of the mouth.

Disagree with Nikos, tho. Under IV sedation you should not be left alone to care for young children, for 12 hours, without a responsible adult present.

It's definitely worth asking about local.

I had my top wisdom teeth out under local (were through the gum and roots were straight- he just yanked them out in about 10 mins), but the bottom ones (impacted and not through) under general. I think in both cases the right decision was made.

The consultant who looked at me for the bottom ones said that it would be possible under local but that he recommended general as it would be quite traumatic for me (due to him having to break the teeth up to take them out)and the risk of me causing further injury to the area by moving my head.

I did oral surgery jobs for a couple of years until I decided it wasn't for me.

I certainly had plenty of patients elect to have wisdom teeth out with just local anaesthetic. You should be offered a choice of anaesthetic, but which is the right choice depends very much on your individual situation.

If the teeth are very deeply impacted, or at a difficult angle, you may well be encouraged towards having a GA as the procedure for removing them can be quite traumatic. If they're visible in your mouth and at an OK angle then it's no different to any tooth extraction and should be fine under local. If you need all four wisdom teeth out then it would probably take more than one visit with local, as many oral surgeons/dentists don't like leaving you with the whole of your mouth numb.

At the hospital where I worked, the waiting list was actually longer for local than GA, but I would expect that it varies from place to place

Differentnameforthis - I did say that she couldn't look after children for the rest of the day!!!

Thanks BaggedandTagged - I will definitely be asking those questions (because people have said they need to be taken out from 15 years ago, I've had some of the risks, like nerve damage, explained to me a few times).

bunnygirl80: thanks - two that definitely need to come out are lower opposite sides, and the 6 is upper, so that is interesting to know (hospital is not difficult to get at, thankfully). That's really interesting that the waiting list was longer for local than general in your area - my last PCT was >3 years for general...hopefully that will factor in, as at least one of the teeth is fairly antibiotic resistant now.

Sorry nikos...I miss read unable, as able!

my dentist wanted to sedate me for having a wsidom tooth out as i am terrified of the dentist, i wasn't happy and requested a local, he refused, i since then found a very patient dentist who is excellent with nervous patients and he said no reason why i couldn't have local and he was happy to do it, i have since changed to him, i flet nothing under the local, ask for numbing gel before injection as i am not good with needles either, i had no probs with any swelling, blleeding, bruising after.

definately request local

i had an impacted wisdom tooth taken out by a maxillofacial surgeon at my dentists surgery under LA.

the surgery had the surgeon come once a month (saturday morning) and although it was pretty traumatic during the proceedure it did heal faster than anybody i've seen have it done under GA.

Thanks pinkkoala and fluffles - it will probably be a maxillofacial surgeone (or trainee). That's interesting that you felt it healed quicker, and two more votes for at least asking...

Having it on a Saturday is convenient too (in terms of time off) - my local hospital started doing this recently under a public/private partnership, but I wasn't eligible unfortunately

yes, i was definitely less bruised than those who have it under GA. i guess because i could hold my mouth open for them and also i suspect they treat awake people with a bit more gentleness.

my friend has all hers out under general and was in a much worse state than me after having mine out by local.

i had a bruised gum later that night and a bit of pain but nothing like i expected.

definately local.

It seems I don't get a choice